Relapsing insulin-induced lipoatrophy, cured by prolonged low-dose oral prednisone: a case report View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2011-12-06

AUTHORS

Ernst A Chantelau, Ruth Praetor, Jörg Praetor, Ludger W Poll

ABSTRACT

INTRODUCTION: Circumscript, progressing lipoatrophy at the insulin injection sites is an unexplained, however rare condition in diabetes mellitus. CASE PRESENTATION: We report a case of severe localised lipoatrophy developing during insulin pump-treatment (continuous subcutaneous insulin infusion) with the insulin analogue lispro (Humalog®) in a woman with type-1 diabetes mellitus. After 11 months of progressing lipoatrophy at two spots on the abdomen, low-dose prednisone (5-10 mg) p.o. was given at breakfast for 8 months, whereby the atrophic lesions centripetally re-filled with subcutaneous fat tissue (confirmed by MRI) despite ongoing use of insulin lispro. However, 4 weeks after cessation of prednisone, lipoatrophy relapsed, but resolved after another 2 months of low-dose prednisone. No further relapse was noted during 12 months of follow-up on insulin-pump therapy with Humalog®. CONCLUSION: Consistent with an assumed inflammatory nature of the condition, low-dose oral prednisone appeared to have cured the lipoatrophic reaction in our patient. Our observation suggests a temporary intolerance of the subcutaneous fat tissue to insulin lispro (Humalog®), triggered by an unknown endogenous mechanism. More... »

PAGES

33-33

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/1758-5996-3-33

DOI

http://dx.doi.org/10.1186/1758-5996-3-33

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1006180689

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22145998


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